The medical profession has long recognized the correlation between the time it takes a patient to receive medical attention and the success and cost of treating the patient. The time it takes a patient to receive medical care and the quality of that care, both immediately after an accident (or unexpected illness) and during transportation to a permanent medical facility, are major factors in the probability of the patient's survival and the patient's recovery rate. Rapid transportation combined with proper training and education of on-site attendants have become important considerations in sophisticated health care delivery systems.
Aircraft, specifically helicopters, are commonly used to transport seriously injured patients to health care facilities. In order to use aircraft for medical purposes, the aircraft interior must be capable of accommodating the equipment and supplies necessary for proper care during transportation, in addition to one or more medical attendants who should have convenient access to the equipment, supplies, and, most importantly, the patient.
Present emergency medical vehicles, both ground and air, have a variety of equipment and supplies on board to serve the health care needs of patients having different injuries and illnesses. In many instances, the equipment and supplies must be installed and stored in confined spaces. In this regard, the interior of the vehicle must be well planned to ensure the accessibility of the attendant or attendants to the equipment, supplies, and the patient or patients.
Weight is an important factor when designing aircraft interiors. Specifically, the components of the interior of an emergency medical vehicle must be small and lightweight without sacrificing strength. While weight and strength are factors for both ground and air vehicles, they are particularly important for aircraft, considering the speed of the aircraft and the potential for heavy impacts wherein components must be lightweight yet strong. Currently, there is a trend to design components of aircraft interiors to withstand 16 g forward crash forces, which far exceeds requirements for ground vehicles; this requirement places even greater emphasis on the aircraft interior design and layout, and the equipment and components making up the medical interior.
Aircraft adaptable to medical missions can generally accommodate the weight of at least three passengers and up to as many as 32 passengers depending on the size of the aircraft. However, when one or more of the passengers is being transported in a prone position (as is necessary for medical purposes), the arrangement of the cabin interior affects the efficiency of treating the patient and the ability to accommodate a maximum patient load. If the interior is not properly configured, an aircraft readily capable of transporting two or more patients may be limited to a single patient. Hence, additional trips must be made with the aircraft, thereby increasing the expense in transporting two or more patients to a medical facility. Ultimately, the weight-carrying performance capability of the aircraft remains an unused resource. In addition, while the interior of some aircraft may be designed for two or more patients, inefficiencies in design of the interior can result in attendants preferring that only one patient be transported at a time due to inaccessibility to the patients when two or more patients are transported together, or wherein the equipment necessary to carry the second patient is so cumbersome that the attendants remove it from the aircraft, making it unavailable when needed. The culmination of inefficient medical vehicle interiors is a financial waste and a heavy burden on the medical facility sponsoring the vehicle, which is ultimately passed on to the patient and/or the patient's financial provider.
If a particular medical facility or geographic region needs an aircraft that accommodates two or more patients, but cannot justify--from a cost-based analysis--the purchase and operation of an aircraft large enough to accommodate two or more patients, the facility must make due with a smaller aircraft. In this regard, if there were an efficient aircraft medical interior design which would allow the smaller aircraft to readily accommodate two or more patients, the health care delivery service would not be compromised because of its choice to operate a smaller aircraft due to limited financial resources.
During transfer and transportation of injured and/or ailing patients to a medical facility or between medical facilities by an emergency medical vehicle, such as an ambulance, helicopter, or airplane, the patient is usually carried on a stretcher. While on the stretcher the patient frequently requires the aid of portable medical equipment such as monitors, defibrillators, oxygen tanks, intravenous bags, and intravenous pumps. The equipment must be continually located close to and often be connected to the patient during transport from the scene of the trauma or transferring medical facility, on the stretcher into the emergency medical vehicle, during the vehicle ride, and, subsequently, out of the vehicle to the proper location in the destination medical facility. The equipment should also be easily removable as a unit.
Time, space, and manpower are the principle constraints. Only one or two attendants are typically available to serve the patient's needs during the entire transfer and transportation process. These attendants cannot efficiently or effectively attend to the patient's medical needs and carry all the necessary equipment while transporting the patient. Space is also limited due to the small size of the vehicle. If more than one patient is being transported in the same vehicle at the same time, space for medical equipment for each patient is even more limited. Hence, there is a further need for a patient transporting vehicle to be readily adaptable to carrying equipment not necessarily considered a permanent part of the aircraft interior.
One example of a prior art device to move equipment with a stretcher is disclosed in U.S. Pat. No. 4,783,109 (Bucalo). The patent describes a frame structure clamped to a stretcher for holding medical equipment. The structure provides shelves for medical equipment. However, the structure is not quickly removable from the stretcher. The clamps are screwed together onto the stretcher frame so as to remain permanently with the stretcher. The structure also does not provide places to support clamp-on or hanging equipment or supplies such as intravenous bags, intravenous pumps, and monitors.
No efficient method or apparatus is known for supporting a number of pieces of portable medical equipment in such a way that they are close to the patient, transportable with the patient and stretcher, and yet easily removed as a unit.
In ambulances and other emergency/rescue vehicles such as helicopters, removable stretchers or patient litters are often provided for convenient and comfortable patient transfer and transportation. The litters for emergency medical aircraft use are somewhat standard, most using a Ferno #9 litter or the like. Such litter includes a structural tubular frame to provide lightweight support for the patient. The litter includes wheels to support its head end and legs to support its foot end. Once the patient is carried or rolled on the litter to the helicopter, the litter is placed within the helicopter and fastened into position for safe transportation.
When a stretcher or litter is placed within an emergency medical vehicle, it must be secured in place to prevent upset or injury not only to any patient who may be lying on the stretcher, but also to others nearby. However, for efficiency and safety, several other considerations exist beyond simply positively securing the litter within the vehicle. Any stretcher securing or locking system must be easy to use since time is often a critical factor and delays can be costly. The system should also be constructed to secure standard litters. Another consideration is space. The locking system should be small with a flat cross section, especially when not in use, to avoid catching on persons, objects, or portions of the litter. The locking system must also be clear of other tables or trays that may be used above or below the locking system.
Several devices have been developed to secure a stretcher or litter for air or ground transport, all with various drawbacks and limitations. U.S. Pat. No. 4,115,884 (Keogh) discloses a litter supporting and locking structure adopted for use in aircraft. The patented device allows a litter to be mounted above aircraft seats with hooks securing the frame of the litter. However, the litter must be carefully placed within these hooks, which may be time-consuming and awkward when a person is supported on the litter. The system disclosed may not be convenient for helicopters or other aircraft with tight space requirements.
U.S. Pat. No. 5,092,722 (Reazer, III et al.) discloses another fastening device for stretchers or litters, including a longitudinal guide track with walls that hold a special projection from the litter and prevent it from moving laterally or vertically. Locking gates along the track impede longitudinal movement once the litter is in place. This device, however, will not secure standard aircraft litters without modification to include the special projections.
Frequently, more than one patient must be transported simultaneously. To be able to use the same vehicle, more than one station or table on which to secure stretchers or litters must be provided so that two or more can be safely and conveniently secured within one vehicle. However, space may be quite limited such that extra tables may be awkward to keep on board or hazardous in an emergency landing if the second litter is inadvertently left unsecured. Since an extra table must be kept clear while loading the first patient on the first litter or when loading only one patient and since adequate space may not exist to fold up and store an extra table when not in use, it may become cumbersome for the medical attendants to continually reposition the second litter. The attendants may choose not to use the second litter thus reducing the aircraft to a single patient aircraft. Therefore, a need exists for an apparatus including at least two litter tables or supports to secure litters while not interfering one with another.
Considering the limitations and disadvantages of the devices and methods currently in use, it should be apparent that effective solutions to the problems of transferring and transporting patients in an emergency medical vehicle, such as a helicopter, including necessary equipment and supplies, and releasably securing a stretcher or litter within the vehicle are not provided in the known prior art.